Citation NR: 9623893
Decision Date: 08/13/96 Archive Date: 09/03/96
DOCKET NO. 94-23 478 ) DATE
)
)
On appeal from the
Department of Veterans Affairs Regional Office in St. Louis,
Missouri
THE ISSUE
Entitlement to service connection for impotency.
REPRESENTATION
Appellant represented by: Disabled American Veterans
ATTORNEY FOR THE BOARD
W. Pope, Counsel
INTRODUCTION
The veteran had active service from December 1967 to May
1969. Service connection has been established for post-
traumatic stress disorder (PTSD).
This matter comes before the Board of Veterans' Appeals
(Board) on appeal from a February 1993 rating decision of the
Department of Veterans Affairs (VA) Regional Office (RO) in
St. Louis, Missouri.
CONTENTIONS OF APPELLANT ON APPEAL
The veteran contends that service connection is warranted for
impotence because it is due to his service-connected PTSD.
In his May 1994 Substantive Appeal, the veteran reported that
he takes clomipramine for his PTSD, and that a doctor at the
VA Medical Center in Fayetteville, Arkansas, told him that
the medication was contributing to his impotency.
DECISION OF THE BOARD
The Board, in accordance with the provisions of 38 U.S.C.A.
§ 7104 (West 1991 & Supp. 1995), has reviewed and considered
all of the evidence and material of record in the veteran's
claims files. Based on its review of the relevant evidence
in this matter, and for the following reasons and bases, it
is the decision of the Board that the veteran has failed to
meet his burden of submitting evidence sufficient to justify
a belief by a fair and impartial individual that he has
presented a well-grounded claim of entitlement to service
connection for impotence.
FINDING OF FACT
Impotence was initially manifested many years after the
veteran's active military service and has not been shown to
be related to service or to a service-connected disability.
CONCLUSION OF LAW
A well-grounded claim for service connection for impotency
has not been submitted. 38 U.S.C.A. §§ 1110, 5107 (West
1991); 38 C.F.R. §§ 3.303, 3.310(a) (1995).
REASONS AND BASES FOR FINDING AND CONCLUSION
Service connection may be granted for a disability which is
shown to have been incurred in or aggravated by service or
which is proximately due to or the result of a service-
connected disease or injury. 38 U.S.C.A. § 1110; 38 C.F.R.
§ 3.310(a). However, under 38 U.S.C.A. § 5107(a), a veteran
has an initial burden to produce evidence that a claim is
well-grounded or plausible. See Grottveit v. Brown, 5
Vet.App. 91, 92 (1993); Tirpak v. Derwinski, 2 Vet.App. 609,
610-11 (1992).
The veteran’s service medical records are negative for
evidence of impotence.
During a March 1992 VA psychiatric examination, the veteran
reported a three-month history of impotence. The diagnosis
was obsessive compulsive disorder (OCD), described as mild to
moderate in degree. The examiner noted that the veteran had
not been taking any medication for the disability.
VA outpatient treatment records show that the veteran
reported a five-month history of impotency in May 1992 and
denied taking psychiatric medication. In August 1992, the
veteran reported a history of impotence since January 1992.
A December 1992 VA psychiatric examination disclosed that the
veteran had been married for 12 years and had three children
from that marriage. He had been married twice before and had
one child from the first marriage. During a mental status
examination, the veteran described classic symptoms of OCD,
of more than 20 years’ duration. The diagnoses were PTSD and
OCD. It was noted that the veteran had recently started
taking clomipramine.
A statement from the veteran’s spouse, received in March
1993, reported that the veteran had been impotent for
approximately 15 months, beginning about January 1992. The
veteran had experienced the problem a few times earlier in
the marriage, but the difficulty had not lasted as long as
the current problem.
During a VA outpatient session on April 13, 1993, the veteran
reported that he felt good on the clomipramine. He noted
that his OCD symptoms had been greatly reduced, his mood had
improved, and he slept better.
A report of a VA urological examination disclosed that the
veteran had been referred for examination due to a two- to
three-month history of left hydrocele and impotency. The
veteran stated that he smoked, had an occasional drink, and
took antidepressant pills. The examination revealed a cyst
of the left epididymis. The veteran was advised to stop
smoking and to check with the psychiatrist about the pills.
During a VA outpatient session in June 1993, the veteran
stated that he had been seen in the urology clinic for
impotence and had been told that the clomipramine might be a
contributing factor, along with cigarette smoking.
During a December 1993 VA general medical examination, the
veteran alleged impotency due to PTSD. The impotence had
begun in January 1992. The veteran had received urological
evaluations and stated that the urologist told him that no
organic cause had been found for the problem. No treatment
had been given. The veteran was able to obtain an erection
only every three or four weeks. A physical examination
revealed that the veteran’s penis, scrotum and testes were
within normal limits. His prostate was boggy and tender.
The diagnoses included impotency of undetermined etiology,
and prostatitis.
A review of the record shows that the veteran’s complaints,
first voiced many years after his separation from service,
were the first evidence of impotence. While the veteran
asserts that his impotence is caused by clomipramine, which
he takes for his service-connected PTSD, he has not presented
any medical evidence substantiating that clomipramine is
producing his impotence. In fact, the only diagnosis
concerning his impotence states that it is “of undetermined
etiology.”
Furthermore, the evidence of record indicates that the
veteran has had several episodes of impotence during his
current marriage; the latest episode began in January 1992.
It is significant that he began taking clomipramine in late
1992 and that clomipramine was prescribed for OCD rather than
PTSD. In short, the only evidence supporting a relationship
between the veteran’s PTSD and his impotence are the
veteran’s assertions.
In this regard, the United States Court of Veterans Appeals
(Court) has observed “that establishing service connection
requires a finding of the existence of a current disability
and a determination of a relationship between that disability
and an injury or disease incurred in service or some other
manifestation of the disability during service." Cuevas v.
Principi, 3 Vet.App. 542, 548 (1992) (emphasis added);
Rabideau v. Derwinski, 2 Vet.App. 141, 143 (1992). Service
connection on a secondary basis is warranted only for a
disability which is proximately due to or the result of a
service-connected disease or injury. 38 C.F.R. § 3.310(a).
The unsupported lay assertions presented by the veteran
concerning such questions of medical diagnosis or causation
are not competent evidence. See Grottveit, 5 Vet.App. at 93;
Espiritu v. Derwinski, 2 Vet.App. 492, 494-95 (1992).
The Board has considered the veteran’s statements to the
effect that he has been told by treating physicians that
clomipramine was contributing to his impotence. However, the
Court, in addressing such evidence, has held that a layman’s
account, filtered through a layman’s sensibilities, of a what
a doctor purportedly said is simply too attenuated and
inherently unreliable to constitute medical evidence required
to render a claim well grounded. Robinette v. Brown, 8
Vet.App. 69, 77 (1995).
The Board accordingly finds that the veteran has failed to
submit evidence of a well-grounded claim for service
connection for impotence. See Grottveit, 5 Vet.App. at 92;
Tirpak, 2 Vet.App. at 610-11.
ORDER
As a well-grounded claim of entitlement to service connection
for impotency has not been presented, the appeal is denied.
WILLIAM W. BERG
Acting Member, Board of Veterans' Appeals
The Board of Veterans' Appeals Administrative Procedures
Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, 741
(1994), permits a proceeding instituted before the Board to
be assigned to an individual member of the Board for a
determination. This proceeding has been assigned to an
individual member of the Board.
NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West
1991 & Supp. 1995), a decision of the Board of Veterans'
Appeals granting less than the complete benefit, or benefits,
sought on appeal is appealable to the United States Court of
Veterans Appeals within 120 days from the date of mailing of
notice of the decision, provided that a Notice of
Disagreement concerning an issue which was before the Board
was filed with the agency of original jurisdiction on or
after November 18, 1988. Veterans' Judicial Review Act,
Pub. L. No. 100-687, § 402, 102 Stat. 4105, 4122 (1988). The
date which appears on the face of this decision constitutes
the date of mailing and the copy of this decision which you
have received is your notice of the action taken on your
appeal by the Board of Veterans' Appeals.
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